Read the answers to some frequently asked questions below about Personal Independence Payment (PIP) for people with a learning disability.
Your frequently asked questions
We've given answers below to some of your questions around PIP.
Click each question to reveal the answer.
What is Personal Independence Payment (PIP) made up of?
Like DLA, PIP has a Daily Living (Care under DLA) component and a Mobility component. Awards will be made up of one or both of these components. Each component has two rates – standard and enhanced. Unlike DLA which had three rates of care, PIP just has the two - there is no lower rate of care.
Weekly rates from April 2017
Daily Living (called ‘care’ under DLA):
- Standard rate: £55.65
- Enhanced rate: £83.10
- Standard rate: £22.00
- Enhanced rate: £58.00
The Daily Living enhanced rate of PIP is the same as the higher rate care component of DLA. The standard rate of the Daily Living component is set at the same level as middle rate DLA care component. The mobility rates of PIP are the same as the DLA rates.
As there is no longer a lower rate of care, many people in receipt of lower rate care DLA are expected to lose their care component when assessed for PIP. However, they may still qualify for a mobility payment.
Will there be automatic entitlement to PIP for people with certain conditions, like DLA?
No. Entitlement for the new benefit will be based on how someone’s conditions or disabilities affect them, not the condition or disability itself.
The Department for Work and Pensions (DWP) has taken the approach that the only way to accurately decide who should get the new benefit is to assess everyone individually, looking at their personal circumstances and barriers they may face.
The assessment for PIP aims to make greater use of evidence from the people who support an applicant (e.g. a GP, support worker or specialist nurse). The majority of people who make a claim will be assessed face-to-face. This is different to DLA claims, where there were no face-to-face assessments, and expert evidence was rarely requested
Exceptions will be made for claimants who are terminally ill and who are not expected to live for more than six months. These claims will be fast-tracked.
If I get DLA, am I entitled to PIP?
There is no automatic transfer from DLA to PIP.
If you already get DLA, and are of an eligible age, you will need to make a claim for the new benefit when invited to do so by the DWP. Your eligibility will then be assessed.
The DWP will write to let you know when and how you can make a claim for PIP. However, we advise that you start thinking about the claim before then and to start gathering additional evidence as soon as possible (see question 8, below, for details).
Everyone will be individually assessed against the new entitlement criteria. The DWP will examine individual circumstances, and entitlement will depend on how the ability to carry out daily living and/or mobility is affected by your condition or disability.
Unlike DLA, entitlement does not depend on what health condition or disability you have. It solely depends upon the effect that their condition or disability has on your daily living and/or mobility.
If I was found ineligible for DLA, will I also be ineligible for PIP?
The criteria and assessment for PIP are different to DLA. While it is likely that some people who were eligible for DLA may be ineligible for PIP, there's also the possibility that some people who were ineligible for DLA may be found eligible for PIP.
This is especially true for the mobility aspect of PIP, which is likely to better reflect the barriers faced by people with a learning disability in planning and making a journey.
If you're not in receipt of DLA, there is no harm in applying for PIP now. However, if you are in receipt of DLA currently, applying for PIP early carries the risk of a reduced award, or the claim being rejected.
How will my entitlement be assessed and decided?
The assessment for PIP focuses on health professionals considering your personal circumstances, to understand how your condition or disabilities affect you. The health professionals, from Atos or Capita (the companies contracted to conduct assessments), depending on the region, then make a recommendation to the DWP which makes the final decision on entitlement and duration of award.
The health professional will consider additional evidence provided by you, or what they source themselves, and any professionals that may support you on a regular basis (e.g. GP or consultant).
Crucially for people with a learning disability, they will also consider non-medical evidence such as a statement from your social worker, educational establishment or a care plan. The health professional may seek this information out on your behalf, providing that you've written it on the claim form (see next question).
However, most people will also be invited to a face-to-face consultation with this health professional as part of the claim process. You are encouraged to bring a companion/advocate with you to this. The health professional will provide a report to a benefit decision maker at the DWP. The benefit decision maker will then use all of this information to decide whether you're entitled to PIP, at what rate and how long the award is for.
You can ask to record the assessment if you wish. You will need to contact the Centre for Health and Disability Assessments to arrange this before you go to the assessment - there are certain requirements you need to follow. You can find more details about the CHDA on their website, or by calling 0800 288 8777.
The claim process, from application to decision, was originally envisioned to take 12-16 weeks. However, once PIP is awarded, the DWP will backdate payments to the date of application, meaning that you will receive all PIP payments that you were eligible for from the date that you applied.
An in-depth booklet discussing the entire process, including the descriptors used, is available from Disability Rights UK.
How long do I have to return the main claim form once I've received it (called the PIP2 form, ‘how your disability affects you')?
You have 28 days to return the form, from the date that the PIP2 form is created.
It's best to assume that you have 28 days to return the form, from the date that the initial claim phone call is made. As the form will be returned using second class post, it is advised to allow four working days for the form to be returned. It can take up to 10 days from the date of the phone call to receive the form.
This is a small window to complete and return the form, especially when taking into account the fact that many people will need to make advice appointments.
Extensions to the deadline are available on request for people who need them – reasons accepted by the DWP include:
- waiting for an advice appointment
- an inability to complete the form alone
- illness resulting in an inability to complete the form
It is advised that you request an extension if you believe that you may not make the initial deadline.
What is additional evidence?
Additional evidence (or "further medical evidence") is really important when claiming PIP. A GP is often the first port of call for people claiming PIP, but they're not the only source of information. Non-medical professionals often know much more about the claimant’s daily life. Therefore you should list both medical and non-medical professionals as sources of evidence on the claim form. Sufficient evidence will support the claim, and may spare a face-to-face assessment; as the health professional may be able to make a recommendation based upon the evidence alone.
While ultimate responsibility lies with the assessment providers to gather evidence, it's important that you gather and submit as much additional evidence as possible (see examples below). This is due to the assessment providers having poor return rates when they ask for additional evidence from professionals, and because they don't have to contact everyone suggested on the claim form.
Official guidance states that you should only submit evidence that you currently have available. However, you may be able to ask people, such as a support worker, teacher or nurse, to simply write a brief letter to submit with their claim. If possible, it's recommended that you find useful additional evidence as early as possible.
While most evidence will be free to source, some professionals may charge. The DWP will not reimburse any costs incurred in obtaining evidence. To avoid paying for evidence you should list those charging for evidence on the claim form for the DWP to contact themselves, instead of you contacting directly. If you have been in receipt of DLA, it's likely that you will already have evidence in your existing file. To reuse this evidence, you must tell the DWP when making the initial claim. The DWP do not always ask about this, so you should proactively ask themselves.
Examples of useful evidence includes, but is not limited to (you can send in whatever you think will be useful for the claim), the following:
- Care Plan
- diary sheets
- supporting statement/information from family or friends
- information from a social worker
- educational records
- statement from teacher/headteacher
- consultant’s report
- community nurse statement
- GP letters.
What if I'm unhappy with the PIP decision?
You have the right to request that the DWP reconsider their PIP award decision. This is called a ‘mandatory reconsideration’.
This must be requested within one calendar month of the decision being made (i.e. one month after the date on the DWP decision letter), except in exceptional circumstances where an extension may be granted upon request.
If you're not satisfied with the decision of their mandatory reconsideration, you can appeal to a first-tier tribunal. A mandatory reconsideration must be undertaken before an appeal will be allowed, however. If the mandatory reconsideration is not requested within the time period given, then an appeal will not be possible. If you have any questions about this or need help with an appeal, please contact Mencap Direct on 0808 808 1111 or firstname.lastname@example.org.
If you are found eligible for PIP, or for a higher rate, through mandatory reconsideration or appeal, the DWP will backdate their claim to date of application and you will receive all of the PIP payments that you were eligible for from the day that you put in your claim.
If I'm awarded PIP will I need to undergo further assessments in the future?
All awards are time-limited, unlike DLA, with the maximum award length being 10 years. The majority of awards are much shorter than this, however.
The Case Manager working on your application decides the period of an award based on all the evidence they are presented with, and makes a decision whether a review or 'planned intervention' will apply, as well as when the review date should be set for.
This section will be updated as new information becomes available surrounding planned interventions.
If a child is under 16 years old, will they be affected by the introduction of Personal Independence Payment?
The DWP will contact children receiving child DLA approaching age 16 or their appointee and advise what they need to do to claim PIP from their 16th birthday. They will also contact their parent/guardian to make them aware of the need to make a claim.
Will these changes affect pensioners who receive DLA?
Only DLA claimants who were over the age of 16 and under the age of 65 on the 8 April 2013 or who reach the age of 16 after October 2013 will be asked to claim the new benefit.
If you're aged 65 or over on 8 April 2013 you will not be able to claim Personal Independence Payment and will continue to receive DLA for as long as you meet the entitlement conditions for that DLA. If their DLA award expires after turning 65, you may be able to apply for Attendance Allowance.
If you were aged 64 or under on 8 April 2013 and turn 65 once PIP has been introduced, you will need to be reassessed for PIP.
Will people on Attendance Allowance (AA) be affected by these changes?
No. People on AA will not be affected by the introduction of PIP, as people on AA will be over 65 and therefore ineligible to apply for PIP as a new claimant. People in receipt of PIP at age 65 will continue to receive it for the duration of their award, as long as they remain eligible.
Will there be a break in benefit payments if someone moves from DLA to PIP?
If you apply for PIP when asked by the DWP and by their deadlines, DLA will continue to be paid until a decision is made on PIP.
This is why it is important to be prepared for PIP, and to ensure that you start to gather evidence as soon as possible. The DWP will post several letters in the months before they have to claim PIP, so you should watch for these.
However, these forms are not currently proactively being sent in accessible formats for people with a learning disability and some people may find it difficult to understand them. Once DLA is stopped, it is very difficult to get it reinstated therefore, as far as possible, you should be supported throughout the process and should be notified to expect PIP letters.
If I currently have a Blue Badge and a carer who receives carer’s allowance because of their DLA, will PIP provide the same “gateway” or “passport” to the additional help and support that DLA attracts?
For people already in receipt of DLA, assuming their award level stays the same under PIP, there should be no problems with keeping these benefits.
The daily living component will help carers qualify for Carer’s Allowance, while the enhanced rate of mobility allowance should help people to apply for blue badges, if they qualified under the mobility component.
However, if you only qualified for the enhanced mobility under the ‘planning and executing a journey’ category, you will not automatically be entitled to a Blue Badge, and whether you receive one will be down to the discretion of your local authority.
How to get the support you need
Contact Mencap Direct, our advice and support helpline, for guidance and information about what support we can offer you.
Or why not take a look at FamilyHub? This is our online community for parents and carers of people with a learning disability, and is a place for sharing experiences, advice and support.